Early- and Long-Term Outcome Data of Patients With Pseudomyxoma Peritonei From Appendiceal Origin Treated by a Strategy of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

Chua, Terence C.; Moran, Brendan; Sugarbaker, Paul H.; Levine, Edward A.; Gléhen, Olivier; Gilly, François Noël; Baratti, Dario; Deraco, Marcello; Élias, Dominique; Sardi, Armando; Liauw, Winston; Yan, Tristan D.; Barrios, P.; Portilla, Alberto Gómez; Hingh, Ignace H. J. T. de; Ceelen, Wim; Pelz, Joerg; Piso, Pompiliu; González-Moreno, Santiago; Speeten, Kurt Van der; Morris, David L.

doi:10.1200/jco.2011.39.7166

Cited by 883 publications

(656 citation statements)

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“…Cytoreductive surgery and HIPEC is now the standard of care of pseudomyxoma peritonei and peritoneal mesothelioma. [31,32] It is considered the standard of care for colorectal peritoneal metastases with a limited peritoneal spread. [33,34] It is also shown benefit for gastric cancer with limited peritoneal spread and has been the only modality that has the potential to prolong survival in this sub group of patients with a very poor prognosis otherwise.…”

Section: Rationale For Hyperthermic Intraperitoneal Chemotherapy (Hipec)mentioning

confidence: 99%

The role of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Ovarian Cancer: A Review

Bhatt

Gléhen

2016

Indian J Surg Oncol

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Ovarian cancer is one of the leading causes of cancer related deaths in women worldwide. It is usually diagnosed in an advanced stage (Stages III and IV) when peritoneal cancer spread has already occurred. The standard treatment comprises of surgery to remove all macroscopic disease followed by systemic chemotherapy. Despite all efforts, it recurs in over 75 % of the cases, most of these recurrences being confined to the peritoneal cavity. Recurrent ovarian cancer has a poor long term outcome and is generally treated with multiple lines of systemic chemotherapy and targeted therapy. The propensity of ovarian cancer to remain confined to the peritoneal cavity warrants an aggressive locoregional approach. The combined treatment comprising of cytoreductive surgery (CRS) that removes all macroscopic disease and HIPEC (Hyperthermic Intraperitoneal Chemotherapy) has been effective in providing long term survival in selected patients with peritoneal metastases of gastrointestinal origin. Intraperitoneal chemotherapy used as adjuvant therapy has shown a survival benefit in ovarian cancer. This has prompted the use of CRS and HIPEC in the management of ovarian cancer as a part of first line therapy and second line therapy for recurrent disease. This article reviews the current literature and evidence for the use of HIPEC in ovarian cancer.

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Section: Rationale For Hyperthermic Intraperitoneal Chemotherapy (Hipec)mentioning

confidence: 99%

The role of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Ovarian Cancer: A Review

Bhatt

Gléhen

2016

Indian J Surg Oncol

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“…For patients with clinically indolent, low-grade disease, cytoreductive surgery with a goal of dramatically reducing or eliminating all tumor burden has been shown to substantially prolong survival. [15][16][17][18][19][20] Systemic chemotherapy is believed to be of little benefit for most patients with indolent peritoneal disease. 12,15,21 For patients with disseminated high-grade mucinous adenocarcinoma that is likely to pursue a more aggressive clinical course, the inherent risks of aggressive surgical debulking and cytoreduction must be carefully considered against the reduced likelihood of prolonged survival.…”

mentioning

confidence: 99%

“…[15][16][17][18][19][20] Systemic chemotherapy is believed to be of little benefit for most patients with indolent peritoneal disease. 12,15,21 For patients with disseminated high-grade mucinous adenocarcinoma that is likely to pursue a more aggressive clinical course, the inherent risks of aggressive surgical debulking and cytoreduction must be carefully considered against the reduced likelihood of prolonged survival. Although its effectiveness is not well established, systemic chemotherapy is more likely to be incorporated into a multimodal treatment strategy for tumors that are judged to be clinically aggressive.…”

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confidence: 99%

Clinicopathologic and molecular analysis of disseminated appendiceal mucinous neoplasms: identification of factors predicting survival and proposed criteria for a three-tiered assessment of tumor grade

et al. 2014

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Previous studies have demonstrated that the prognosis of disseminated mucinous appendiceal neoplasms is highly dependent upon tumor grade. Reflecting this, the 7th edition of the American Joint Committee on Cancer (AJCC) staging system now incorporates a three-tier grading system for prognostic staging of mucinous appendiceal tumors. However, the grading criteria are not well described. In order to address this issue, we evaluated clinicopathologic and molecular features of 219 cases from 151 patients with widely disseminated appendiceal mucinous neoplasia treated at our institution between 2004 and 2012. We identified histologic features that were associated with worse overall survival on univariate analysis: destructive invasion, high cytologic grade, high tumor cellularity, angiolymphatic invasion, perineural invasion, and signet ring cell component (all with Po0.0001). We used these morphologic characteristics to classify neoplasms into three grades: AJCC grade G1 lacked all adverse histologic features; AJCC grade G2 had at least one adverse histologic feature (except a signet ring cell component); and AJCC grade G3 were defined by the presence of a signet ring cell component. Patients with AJCC grade G2 and grade G3 adenocarcinomas had a significantly worse prognosis compared with AJCC grade G1 (Po0.0001 for each). A trend toward worse overall survival was identified for patients with AJCC grade G3 adenocarcinomas compared with AJCC grade G2 adenocarcinomas (P ¼ 0.07). Our multivariate analysis found that this three-tier grading system was a significant predictor of outcome (P ¼ 0.008), independent of other prognostic variables. After controlling for other prognostic variables, AJCC grade G2 was associated with a 2.7-fold increased risk of death (95% confidence interval (CI), 1.2-6.2) and AJCC grade G3 was associated with a 5.1-fold increased risk of death (95% CI, 1.7-14) relative to grade G1 tumors. Our results indicate that evaluation of a limited set of adverse histologic features allows for the separation of disseminated mucinous neoplasms of appendiceal origin into three morphologically defined and prognostically relevant grades as advocated by the AJCC.

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“…2. Completeness of cytoreduction (CCR) score [7,8], i.e., removal of all gross disease, as assessed by Chua et al study [15]. When no residual disease remained, the CCR score was 0.…”

Section: Discussionmentioning

confidence: 99%

“The Jelly Belly”: Diagnostic Dilemmas and Current Concepts

Kedia

Ravikumar

Mohanty

et al. 2016

J Obstet Gynecol India

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Background Pseudomyxoma peritonei (PMP) is a rare and poorly understood clinicopathological entity characterized by gelatinous ascites with neoplastic or non-neoplastic mucinous implants in the peritoneum. Although its origin was debated, current evidence in literature favours the appendix as the origin of the disease, over the ovaries. The changing terminologies in the classification of this entity pose diagnostic and management challenges. Case Reports Herein, we report three cases of PMP in postmenopausal women, their clinical presentation, pathological staging based on the peritoneal tumor deposits and the treatment administered. Two patients recovered uneventfully, while one had recurrence of adenocarcinoma. Conclusion The rarity of this disease and the diagnostic challenges associated with it are discussed with an emphasis on the current concepts in its origin and management. Appropriate classification and complete removal of the tumor is mandated to prevent disease-related mortality.

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Early- and Long-Term Outcome Data of Patients With Pseudomyxoma Peritonei From Appendiceal Origin Treated by a Strategy of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

Cited by 883 publications

References 24 publications

The role of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Ovarian Cancer: A Review

The role of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Ovarian Cancer: A Review

Clinicopathologic and molecular analysis of disseminated appendiceal mucinous neoplasms: identification of factors predicting survival and proposed criteria for a three-tiered assessment of tumor grade

“The Jelly Belly”: Diagnostic Dilemmas and Current Concepts

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